What is the carpal tunnel? The carpal tunnel is a passageway in the wrist that goes from the lower arm to the hand. It is formed by the bones of the wrist and also the flexor retinaculum (also known as the transverse carpal ligament). Several tendons from the flexor group of muscles found in the lower arm and also the median nerve pass through this tunnel.
Carpal Tunnel Syndrome is where the medial nerve that passes through the carpal tunnel is compressed, and this then has a range of symptoms.
Symptoms of CTS include pain in the surrounding areas of the wrist (the lower arm, fingers and hand), numbness and tingling in the hands and fingers and weakness in the hand with trouble gripping things, especially with the thumb. These symptoms normally onset gradually and are often worse at night and if it isn’t treated the weakness will slowly grow due to muscle wastage in the muscles around the thumb.
What causes CTS is the compression of the median nerve as mentioned above and this compression can be caused by a number of factors but it is usually due to swelling in the wrist. The swelling may be the result of a direct trauma/impact to the wrist, it is mainly due to lifestyle factors such as obesity and lack of exercise (low circulation etc), it can also be quite common in pregnancy where swelling of the joints happens in some women. Careers that involve repetitive wrist action such as typists and computer users can experience CTS, this is due to the repetitive lack of repair in the area causing dysfunction and swelling. There is also evidence that CTS can be hereditary and also the risk increases if a history of wrist injury or other wrist issues.
Normally CTS will go after a few weeks once the swelling has gone down and the pressure on the median nerve has reduced. The healthcare system would recommend things like painkillers and anti-inflammatories to reduce the pain and swelling and wearing a splint at night for about 4 weeks to reduce the movement and allow rest of the joint. If the symptoms get worse steroid injections and surgery have been recommended.
Gentle hand exercises and soft tissue manipulation in the wrist and surrounding areas would benefit a client with CTS as again with the massage strokes warming up the soft tissue and encouraging the release of endorphins it will help with reduction of pain. The stimulation of the soft tissue will also help with the circulation of the blood, lymph and nervous system which in turn will generate more blood to the area and this in turn will help aid the healing process by reducing the swelling and eventually ease pressure on the median nerve.
Should the client seek further advice you would always recommend they visit a GP for proper diagnosis and treatment but ideally refer them and advise them to try soft tissue massage before resorting to surgery.
